(310) Multicomponent interventions to improve adherence and symptom management in patients receiving CDK4/6 inhibitors: A real-world U.S. evidence review
Student MCPHS Boston, Massachusetts, United States
Background: : Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors are a cornerstone of treatment for hormone receptor–positive, HER2-negative advanced breast cancer. However, real-world adherence is often undermined by toxicity, financial strain, and fragmented care, which can compromise progression-free survival and patient-reported outcomes.
Objective: : To systematically evaluate U.S.-based interventions aimed at improving medication adherence, symptom control, and treatment continuity in patients receiving CDK4/6 inhibitors.
Methods: : We reviewed 12 studies published between 2020 and 2025, including randomized trials, retrospective cohorts, and health system implementation programs. Interventions included digital adherence platforms, nurse-led symptom triage, financial navigation services, and pharmacy-integrated models. Extracted outcomes included medication adherence rates, early discontinuation, dose reductions, patient satisfaction, and healthcare utilization.
Results: : Mobile adherence tools were associated with 12 to 25 percent reductions in missed doses. Nurse-led toxicity monitoring reduced unplanned interruptions by 18 to 30 percent and enabled earlier therapeutic adjustments. Financial navigation services reduced early discontinuation in underinsured patients by up to 40 percent. One large health system reported an average of $2,100 per patient in cost savings due to fewer emergency department visits. Interventions that combined digital, clinical, and financial components showed the most consistent gains in persistence and patient experience. However, most programs lacked standardized protocols, limiting scalability. Equity-focused adaptations were rare, and payer engagement was minimal, contributing to inconsistent implementation across systems.
Conclusions: : Real-world support interventions can improve adherence, reduce toxicity-related disruptions, and enhance patient outcomes for individuals receiving CDK4/6 inhibitors. To enable broader and more equitable adoption, future programs should prioritize standardized implementation, culturally responsive design, and alignment with payer reimbursement strategies to support sustainable delivery.
